To request this information in an alternate format, please contact the FOIA Officer at (540) 667-1815 or pio@winchesterva.gov.
Return this form to the FOIA Officer, Communications Office, City of Winchester, 15 N. Cameron Street, Winchester, VA 22601.
City of Winchester, Virginia
To provide a safe, vibrant, sustainable community while striving to constantly improve the
quality of life for our citizens and economic partners.
FOIA Request Form
Pursuant to Code of Virginia 2.2-3700, the Virginia Freedom of Information Act (FOIA), citizens have the right to access public
records. Please print the information below. Some of this information is voluntary and becomes part of the City of
Winchester’s public records. Providing the information requested below will assist the City in fulfilling your request promptly
and accurately. *Designates required.
*Name: __________________________________________________________________________________ Date: _____________________________________________
*Address: _____________________________________________________________________________________________________________________________________
Phone: _____________________________ Fax: _____________________________ Email: _______________________________________________________________
Company/Organization: _____________________________________________________________________________________________________________________
In accordance with the Virginia Freedom of Information Act (§ 2.2-3700 et seq.), I am requesting the following records:
_________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
Check one: Print Records Email Records (when possible) Save Records on CD/DVD
________________________________________________________________________________________ ___________________________________
Signature Date
Charges:
VFOIA [VA Code Ann. Section 2.2-3704 (F) (Supp. 2009)] permits reasonable charges not to exceed the actual
cost incurred in accessing, duplicating, supplying, or searching for the requested records. You may request an
advance estimate of the charges. If the estimated charges exceed $200, a 50% deposit will be required prior to
processing your FOIA request. An itemized FOIA expense form is available upon request.
This section for Communications staff only:
Received ______________________ Response ______________________ Extension _____________________
Complete ____________________
click to sign
signature
click to edit